title: Costs of unnecessary admissions and treatments for "threatened preterm labor".
abstract: OBJECTIVE
  Cervical length (CL) of 3 cm or greater has been shown to have a 97-99% negative predictive value for preterm delivery in women with threatened preterm labor. Consequently, hospitalization and treatment are not indicated in these patients. We analyzed how often patients with a CL of 3 cm or greater are still being admitted and treated for preterm labor and how much this contributes to the economic burden of preterm labor hospitalizations.
  
  
  METHODS
  Twelve month hospitalizations for preterm labor at less than 34 weeks at a single institution were reviewed and patients with a CL of 3 cm or greater were identified. We chose to use patients' hospital charges as a surrogate for health care costs, recognizing that charges are not synonymous with the final patient bill and also do not reflect additional costs such as the cost of treatment at the referring facility, transportation, physician fees, and other such costs as lost wages, need for additional child care, etc.
  
  
  RESULTS
  Between July 2009 and June 2010, 139 patients were admitted and treated for preterm labor at our level III center. Fifty of these patients (36%) had a CL of 3 cm or greater. None of them delivered preterm. Total hospital charges for the management of these patients were $1,018 589 (mean, $20,372; median, $14,444).
  
  
  CONCLUSIONS
  Unnecessary admissions and treatments for threatened preterm labor are part of clinical practice and contribute to exploding health care costs. Using currently available diagnostics, these costs could be lowered significantly without jeopardizing outcome.
authors.affiliation: Department of Obstetrics and Gynecology, St Joseph's Hospital and Medical Center, Phoenix, AZ 85004, USA.
authors.forename: Miha
authors.initials: M
authors.lastname: Lucovnik
authors.forename: Linda R
authors.initials: LR
authors.lastname: Chambliss
authors.forename: Robert E
authors.initials: RE
authors.lastname: Garfield
mesh_terms: D000293:Adolescent; D000328:Adult; D002584:Cervix Uteri / Q000033:anatomy & histology; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007752:Obstetric Labor, Premature / Q000191:economics*; D010343:Patient Admission / Q000191:economics*; D011247:Pregnancy
keywords: cervical length; costs; preterm birth